Coping with fluid restrictions

Fluid restrictions - how much we hate them!!!

Restricting fluid is probably the toughest part about dialysis for most people. The thumb rule given by doctors with regard to the amount of fluid allowed per day is 500 ml + the volume of urine you are producing. What about people who pass no urine? Must they have only 500 ml per day? Very tough!

Let us try to understand the reason behind fluid restrictions. The kidneys as you know, remove the excess fluid from the blood in the body. So, when the kidneys are not functioning adequately, the excess fluid builds up in the body. This can cause the excess water to go into the cells of the body. This causes edema (or swelling of the feet and hands) and it can also cause breathlessness because the excess fluid gets into the tissues of the lungs. This excess fluid can only be removed by dialysis.

The thing with people on dialysis is that we do not drink only when we are thirsty. We drink because we want to drink. In fact, we drink because we've been told not to drink! That's how the human mind is. Crave what you are not allowed to do!

One thing to remember is the internet is filled with people who are in places that are much colder than in India. So, take their figures with a pinch of salt. Generally, in India, it is hot. So, we tend to have more fluid than people in places where the weather is generally cold.

The idea is to not think about fluids. Stay busy. Work, full time if possible. If you're not working, take up a hobby. Watch a movie. When the mind is not thinking about fluids, half the battle is won.

When you must have fluids, try these tips:

- Never gulp down fluid. Always sip it. Relish every sip. Take the most out of every sip. Feel it go down your throat.

- Drink fluids other than water. It is easy to have a large amount of water. It is less easy to have the same amount of fresh lime juice, for example.

- Have very cold or hot fluids. This again helps in reducing the amount consumed because you cannot gulp down a large amount quickly. You can only sip it.

- Reduce the amount of salt. More salt = more thirst.

If you know of a tip that worked for you, let me know.

At the end of the day, NEVER feel guilty if you had too much fluid. Don't let your doctor, family, dialysis staff or even fellow patients scold you for having excess fluids. Tomorrow, if they were to have as fluid restriction, they would probably be less compliant than you are. Tell them this! You have enough to deal with already. You really don't need their advice!